<p>Company Description</p> <p>Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on over 80 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors-our members. If you're passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!</p> <p>Learn more about our unique benefit offerings here.</p> <p>Job Description</p> <p>About the Role: As a people-leader, you will coach, mentor and lead a team dedicated to delivering results related to government programs, specifically Medicare Advantage (MA), initiatives in support of overall Medicare Advantage plan performance through coding accuracy/risk adjustment, care delivery and cost of care programs. These initiatives are comprised of multiple interrelated projects that are interdependent, integrated, and/or highly complex. Prioritization is key in this role. You will effectively collaborate and build strong relationships with health networks and government programs leadership, joint venture leadership, program management, technology, vendor partners and other business functions to drive and achieve government programs objectives and key results.</p> <p>Because this role will be a leader of others, you will directly impact the success, growth, and development of team members. It is critical that you are a role model for behaviors that demonstrate Wellmark's Leader Success Expectations, which includes setting clear expectations, defining accountabilities, providing regular coaching, facilitating change, and providing an overall positive work environment. In addition to outstanding leadership skills, you have a passion for healthcare and leading positive change.</p> <p>About You: Ideal candidates thrive in a startup-like environment, have proven experience in implementing enterprise-wide strategy and program management, and a demonstrated history of cultivating and maintaining strong relationships internally and externally. You possess a strong understanding of the healthcare industry with government health plan knowledge. You are a "strong operator" with a highly organized and results-driven leadership and working style. You may not know everything about Medicare Advantage, but you have a keen ability to listen, retain and synthesize details to develop and monitor programs and initiatives. In addition, you have exceptional organizational change management capabilities, with a track record of driving impactful transformation.</p> <p>Why You Should Join Us: By joining our Medicare Advantage team, you will have the opportunity to significantly impact healthcare's future. You will be a part of a team where innovation, agility, and new ideas are encouraged and celebrated. Your leadership will directly contribute to improving the quality of care for Medicare beneficiaries, optimizing network performance, and positioning our organization as a leader in Medicare Advantage. Check out our opening and apply today!</p> <ul> <li>This position will work a hybrid schedule: Tuesday through Thursday in Wellmark's Des Moines office, with the option to work remotely Monday and Friday. As a leader, there may be additional days in the office to meet business needs. </li></ul> <p>Qualifications</p> <p>Required Qualifications - Must have:</p> <ul> <li>Bachelor's degree or direct and applicable work experience. </li><li>4+ years of related healthcare industry experience that reflects experience managing multiple interrelated projects which are interdependent, integrated, and/or highly complex. </li><li>Strong abilities in the interpretation of data (e.g. outcomes, trends, assessment of benchmark data). Demonstrated problem-solving, quantitative, and analytical skills with the ability to recognize inconsistencies, analyze for reasonableness and accuracy, research and come to conclusion in a wide variety of changing analytical situations. </li><li>Ability to build and maintain strategic, ongoing relationships with colleagues and external stakeholders </li><li>Leadership skills typically gained through a combination of project or informal leadership that demonstrates knowledge of work processes, products and services, and leadership competencies. </li><li>Proven skills in motivating and influencing others; ability to build collaborative relationships across the organization. </li><li>Effective consultation skills, including the ability to persuade and influence key decision makers. </li><li>Demonstrated ability to communicate effectively verbally and in writing, expressing complex concepts clearly and concisely with multiple levels of an organization, including external stakeholders and professional organizations. Ability to develop and facilitate presentations as needed. </li><li>Ability to apply strong analytical, problem solving, and critical and strategic thinking to work with vendors and internal departments. Willingness to take an innovative, creative approach to solving problems and developing solutions. </li><li>Self-starter motivated by the opportunity to work in fast-paced environments and driven by measurable outcomes. Ability to operate independently yet cooperatively on teams to appropriately manage priorities while maintaining positive relations. </li><li>Strong organization, time management, and prioritization skills. Ability to manage multiple projects while adjusting to changing priorities and business needs. </li><li>Ability to develop and maintain documentation of processes and procedures and make decisions by following established guidelines. </li><li>Proficiency with Microsoft Office applications, such as Word, Excel, Outlook, PowerPoint or Access. </li><li>Ability to travel 5-10% of the time, including overnight stays. Valid driver's license required. </li></ul> <p>Preferred Qualifications - Great to have:</p> <ul> <li>Experience leading key strategic initiatives in a matrixed environment </li><li>Experience with CMS Risk Adjustment, Care Delivery (UM and CM) and Network Strategy initiatives strongly preferred. </li><li>Knowledge of contracting and payment strategy, medical policy, benefit designs and product offerings. </li></ul> <p>Additional Information</p> <p>What you will do as a Team Leader for Government Network Programs:</p> <p>a. Provide leadership and day-to-day management of financial and human resources, primarily focusing on employee coaching, development, performance improvement, coordination and budgeting for staff and department(s) specific functions/services. Support business objectives and produce results that are effective, accurate, and timely and on target to meet HR team and stakeholder needs.</p> <p>b. In collaboration with Health Networks and Government Programs and joint venture leadership, define, shape, and drive strategies inclusive of coding accuracy and cost of care.</p> <p>c. Lead a team responsible for government programs network strategies and operations. Provide ongoing monitoring and management of opportunities for total cost of care through care delivery, cost of care, coding accuracy programs, while ensuring the strategic focus is on target with overall company strategy.</p> <p>d. Serve as a key leader on MA project portfolio work as well as partner with agile product owners and product managers on strategic initiatives.</p> <p>e. Facilitate discussions with senior leaders, joint venture partners and cross functional business units to ensure that synergies are aligned to meet government program business objectives and key results.</p> <p>f. Oversee and drive strategic initiatives for Wellmark's relationships with key health care organizations and other strategic stakeholders.</p> <p>g. Oversee the management of end-to-end processes for Wellmark and is accountable for Medicare Advantage care delivery, cost of care and risk programs. Lead the development and maintenance of new processes as needed.</p> <p>h. Partner with internal and external partners and oversee development and maintenance of performance analytics and reporting for the area.</p> <p>i. Continually assess external environment and emergence of coding accuracy and care delivery optimization activities and implications for Wellmark, including analyzing and preparing information to facilitate decision-making.</p> <p>j. Ensure staff are well versed in best practices and of trends and regulations related to government programs. Provide direction to ensure objectives and outcomes are met and interactions are relevant and engaging for the audience.</p> <p>k. Other duties as assigned.</p> <p>This job requires a non-compete agreement.</p> <p>An Equal Opportunity Employer</p> <p>The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.</p> <p>Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com</p> <p>Please inform us if you meet the definition of a "Covered DoD official".</p>